Reply To: Blinatumomab, Dinutuximab, and Other Biotherapy Nurse Staffing Ratios

  • Alyssa Henderson

    Member
    August 30, 2022 at 5:00 pm

    Erin,

    I found 2 articles that reference nurse to patient ratios for dinatuximab but nothing for blinatumomab.  Here’s the info I’ve gathered – not sure if the links will work because I was logged into my medical institution library when I accessed the articles…

    Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523913/#APP1

    Title: The Role of Nursing Professionals in the Management of Patients With High-Risk Neuroblastoma Receiving Dinutuximab Therapy

    APA Citation: Secola R, Marachelian A, Cohn SL, Toy B, Neville K, Granger M, Brentlinger A, Martin G. The Role of Nursing Professionals in the Management of Patients With High-Risk Neuroblastoma Receiving Dinutuximab Therapy. Journal of Pediatric Oncology Nursing. 2017 May/June;34(3):160-172. doi: 10.1177/1043454216680595. Epub 2017 Jan 6. PMID: 28061552; PMCID: PMC7523913.

    Key Points: “Discusses various serious adverse effects of dinutuximab and nursing implications.  All components of the immunotherapy regimen are associated with significant toxicities. The expert assessment and management of AEs, as well as preparation of and collaboration with patients and families, will facilitate patients’ remaining on therapy and receiving the full cycle of treatment, thereby optimizing the possibility of long-term control. Physicians and nurses, particularly those less experienced with immunotherapy, often need support in managing AEs, especially those that are unexpected and uncommon. In the view of many health care providers, a critical unmet need is the lack of appropriate tools and standardized procedures for managing AEs associated with the immunotherapy regimen.”

    • References a sample case study in which the “patient had many adverse effects but remained stable in a heme/onc unit with 1:2 nurse patient ratio”

    Link: https://journals.sagepub.com/doi/full/10.1177/1043454216659448?casa_token=X988tDH8-q4AAAAA%3APBZr-tWrJjncVCnY6TLC4f_AJFujv78JM2ZVSpU1tI71GKr3cC_0TuDnWN0IVgYtE47NXmpi7VQZDw

    Title: Dinutuximab: A Novel Immunotherapy in the Treatment of Pediatric Patients With High-Risk Neuroblastoma

    APA Citation: Bartholomew, J., Washington, T., Bergeron, S., Nielson, D., Saggio, J., & Quirk, L. (2017). Dinutuximab: A Novel Immunotherapy in the Treatment of Pediatric Patients With High-Risk Neuroblastoma . Journal of Pediatric Oncology Nursing, 34(1), 5–12. https://doi.org/10.1177/1043454216659448

    Key Points: “Pediatric oncology nurses play a significant role in the administration of the immunotherapy designed to treat NBL patients. Their knowledge and recognition of common infusion-related complications and toxicities as well as pertinent administration management enable patients to receive this complicated treatment regimen in a safe and timely manner.

    Patient/nurse ratio: Most institutions establish a 2 to 1 patient to nurse ratio on a hematology/oncology inpatient unit. Intensive care monitoring may be necessary for severe toxicity complications.”

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    Alyssa Henderson, RN, BSN, CPHON
    Inpatient Peds Heme/Onc/BMT Staff Nurse
    Hackensack, NJ
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    Original Message:
    Sent: 08-30-2022 11:38 AM
    From: Erin Jones
    Subject: Blinatumomab, Dinutuximab, and Other Biotherapy Nurse Staffing Ratios

    Hi Alyssa,

    I’m in the very same boat right now defending all of our staffing ratios, but especially anything 2:1. I have not been able to find much at all in regards to staffing ratios for pediatric oncology patients, much less staffing ratios for specific therapies, in a literature review. The comments I’ve found here have been my best resource so far, but if you find others, please share!

    We put Dinatuxumab patients in a 2:1 assignment, though staffing constraints continue to make that very challenging. They are usually on a ketamine drip with our pain team managing that component.  Our blinatumomab patients we staff in a 3:1 ratio. I hope you get a robust number of responses to this thread because benchmarking would be helpful!

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    Erin Jones, MHA, BSN, RN, CCRN-K | Patient Services Manager III
    5 Children’s | Pediatric Hematology, Oncology, Bone Marrow Transplant, and Cardiology
    NC Children’s Hospital
    UNC Health
    Chapel Hill, NC
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    Original Message:
    Sent: 08-30-2022 07:34 AM
    From: Alyssa Henderson
    Subject: Blinatumomab, Dinutuximab, and Other Biotherapy Nurse Staffing Ratios

    Hello everyone!
    I am the assistant nurse manager at Hackensack UMC in Hackensack, NJ and I am looking for documentation to support my inpatient unit’s 1:2 nurse:patient staffing ratio for blinatumomab, dinutuximab, and other biotherapy infusions.  I am in the process of conducting a literature search but not having much luck.  Would you mind sharing your hospital name and pediatric biotherapy infusion staffing ratios (specifically blina & dinutux if possible)?  Also, if anyone has literature to support lower staffing ratios for these infusions I would sincerely appreciate it!  Thank you in advance!!

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    Alyssa Henderson, RN, BSN, CPHON
    Inpatient Peds Heme/Onc/BMT Assistant Nurse Manager
    Hackensack, NJ
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